37D2154262 CLIA NUMBER - WALMART PHARMACY 10-0047

Laboratory Demographics

  • CLIA Code: 37D2154262
  • Facility Name: WALMART PHARMACY 10-0047
  • Facility Address: 1101 W RUTH AVE
    SALLISAW, OK
    ZIP 74955
  • Facility Phone: 918 775-5552
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON C. KIRKLAND
  • NPI Number: 1235156365
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2154262
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-0047
Street 1101 W RUTH AVE
City SALLISAW
State OK
ZIP 74955
Phone 918 775-5552
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Pharmacy
Lab Director BRANDON C. KIRKLAND

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This page was last updated on: 9/29/2025